Understanding the Role of DITI* in Breast Screening
(*Digital Infrared Thermal Imaging)
DITI as a screening test in all age groups is designed to establish a baseline (the patient’s normal thermal fingerprint) for ongoing comparative analysis (normally annual) to detect any physiological change that justifies additional testing (which could be physician exam, mammogram, ultrasound, MRI, blood work, hormone testing or a number of other interventions).
There is no comparison or competition between mammogram and DITI, as they are two different tests providing different results! DITI does not provide any of the same findings or information that mammogram or ultrasound provides. Mammogram and ultrasound show “structure” -- tissue densities can be evaluated, lumps can be measured, calcifications can be located and opinions given regarding pathology before biopsy. DITI is a different kind of test which shows information relating to “function” and physiology -- vascular activity, inflammation, lymphatic activity, hormonal dysfunctional and other “functional” abnormalities. DITI cannot detect specific pathology like a biopsy. It cannot detect tumors or micro-calcifications as DITI cannot “see” structure.
The changes that DITI can detect include inflammatory pathology (inflammatory carcinoma/inflammatory breast disease), infection, lymph dysfunction (lymph congestion, lymph node pathology), vascular changes (development of new and abnormal vessels known as “angiogenesis”) and also any suspicious activity outside the range or scope of other tests (outside the border of the breast, in the sternum or axilla). So, again, there is no comparison or competition between different tests.
It takes years for most cancers to develop to the stage that they can be detected with mammogram or ultrasound (dense enough for location and biopsy) so DITI is ideally placed as a screening tool to identify changes over time in the early development stages, before there is more advanced pathology that can be detected with other tests.
There are no contraindications for DITI, as it is totally non-invasive, no radiation of any type and no contact with the body so it can “do no harm”.
DITI results are reported by medical doctors who are certified thermologists and experienced in reading thermograms. The reading doctor takes into consideration all history, symptoms and the results of other tests as included in patient history.
The benefits of DITI do vary between age and risk groups. With the pre-mammogram age group (under 50) and those diagnosed with “dense breast”, the benefits of screening to detect any findings or changes that justify additional testing or closer monitoring are simple. With any positive DITI findings in this younger age group/dense breast group, any mammogram and ultrasound sensitivity and specificity will be increased with the objective DITI findings targeting a dysfunction and location and providing decision-making information in women that would not have otherwise been tested.
The major benefit in this group is in detecting early changes that precede malignant pathology that will become diagnosable at some stage. Early detection is aimed at prevention and if early changes are detected, then we have an opportunity to intervene and change the outcome. The earlier an abnormality is detected, the better the treatment options will be, resulting in a better outcome. (Prevention may include treatment of inflammation, fibrocystic disease, lymph congestion, estrogen dominance and more specific conditions like angiogenesis.)
In patients of mammographic age (generally over 50), post-menopause or when the density of breast tissue has reduced sufficiently to make mammography more effective, DITI not only provides the benefit of early detection of functional change but can also increase the detection rates of other tests by contributing additional information about functional (physiological) abnormality and also the location of suspicious(positive) thermal findings that may be outside the range of other tests due to location, size of breast, implant, or other limiting factors.
DITI does have the potential to create anxiety for a patient (as does mammogram) with equivocal results or results that cannot be confirmed or positively diagnosed but both tests can minimize unnecessary anxiety with better informed consent, education and realistic expectation for the test.
The best possible plan is to use every appropriate test adjunctively to get the highest detection rates without generating additional or unnecessary invasive testing
It would be unfortunate for a patient to forgo a necessary mammogram that was justified, and any decision should be made with consultation between the patient and her doctors based on individual history, symptoms and test results.
Peter Leando PhD. DSc. DAc.
Fellow, Royal Society of Medicine
Fellow, American College of Clinical Thermology
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